Compressive binder devices for severely traumatized pelvic injuries are a well-known treatment in the medical arts. Severe pelvic ring injuries can damage venous and arterial vasculature as well as pelvic and abdominal viscera. Pelvic ring injuries have been shown to have an associated mortality rate of between 10%-50% depending on the severity of the energy imparted to the pelvis. Rapid exsanguination can occur in severe injuries that damage the pelvic vasculature, aggressive management of this hemorrhage with compression has proven to be the optimal initial treatment.
The pelvic binder or sheet is now the standard of care for the initial treatment of most exsanguinating pelvic ring injuries. Some purposes of the binder or sheet are to:                1. Apply a significant amount of constant force to the pelvis in order to reduce the pelvic volume;        2. Splint the bony pelvis to reduce hemorrhage from fractured bone ends and venous disruption;        3. Stabilize and maintain the integrity of the pelvis for future definitive surgical treatment; and/or        4. Reduce pain.        
Conventionally, the binder is applied in a uniform manner that applies pressure on the lateral aspects of the greater trochanters of the hips proximal femurs, so as to compress the hips from the lateral aspect medially. The binder must be applied in a uniform manner so as to distribute the compressive force over a wide surface area on the lateral hips. The uneven distribution of this compressive force has led to the development of pressure induced skin and soft tissue breakdown and necrosis. This soft tissue breakdown and necrosis has been shown to significantly increase the morbidity and mortality of the traumatized patient.
Even with uniform application of a pelvic binder or sheet there is still significant compressive force applied to the pelvis. Skin breakdown and necrosis over bony prominences is still a major complication with the long-term use of a properly applied binder or sheet. Many orthopedic surgeons will elect to remove the pelvic binder after 24 hours and surgically apply an external fixator device in its stead to avoid skin breakdown complications
The surgical application of an external fixator device is not without major possible complications as the patient is often in a critical state of health and even minor insults such as anesthesia or mobilization can quickly cause the patient's status to deteriorate. In many cases the patients' health is in such a precarious state that longer term application of the pelvic binder would allow for the stabilization of their overall health status before they go to surgery for either the application of an external fixator or a more definitive surgery.